Medial Collateral (MCL) Ligament Injury of the Knee, Damaged Knee Ligament, Knee Ligament Sprain
The medial ligament is one of the most commonly damaged knee structures in sports and activities. The knee is vulnerable to the forces we (and other people) put upon our knees as we run, twist, turn and jump, often leading to knee ligament strains, sprains or ruptures.
Luckily the medial knee ligament has a good blood supply and usually heals very well, but it is worth getting advice from a physiotherapist or other sports therapist to ensure you get the best treatment and rehabilitation. That way you will heal up best and can go back to doing what you did before.
The Medial Ligament of the Knee (MCL)
As you can see from the diagram below, the medial ligament runs from the lower part of the inside of the femur (thigh bone) to the upper part of the tibia (shin bone), holding the inside of the knee together. This stops the knee from developing an unhelpful degree of knock-knee position, in other words it, along with the other three main ligaments, maintains the stability of the knee.
It is a big structure and is very strong, with a good blood supply. It allows a backwards and forwards movement of the knee, restricting the sideways bend and contributing to preventing the knee from going further than straight. It stops the inside part of the knee joint widening under stress.
MCL injuries are usually caused by physical force applied to the outside of the knee, such as somebody tackling or colliding with the outside of the leg.
The Severity of Medial Ligament Injury
Injury to a ligament is graded to indicate how severe the damage is. Treatment differs for each grade
This means the ligament has been strained but that it still doing its job well.
This indicates that there is a complete rupture of the medial ligament.
A severe medial ligament sprain or rupture may not occur on its own; other structures such as the anterior cruciate ligament and the menisci may be damaged at the same time.
Management of Medial Ligament Injury
The MCL is a large structure and has a good blood supply. Because of this, unlike most of the knee ligaments it has an excellent ability to heal. In most cases, isolated medial ligament injuries heal without significant long-term problems.
Orthopaedic surgeons have varying opinions about how best to treat medial ligament injuries, but most agree with allowing them to heal without surgery.
Diagnosis and treatment of acute laxity (looseness) of the inner side of the knee is vital as soon as possible. If taken early, a one week course of anti-inflammatory drugs may improve the healing ability of the ligament by up to 50%.
The knee is not usually immobilised in a plaster cylinder but a long-leg, hinged brace is often used for 4 to 6 weeks. The range of motion of the knee is often kept restricted for a while, because full bend or full straightening of the knee pulls on the medial ligament.
Full weight-bearing on the leg is usually allowed, and the person sent to physiotherapy for rehabilitation.
Treatment for Medial Ligament Injuries of the Knee
All acute injuries vary but most are managed using the PRICE system.
MCL injuries are best treated with early range of motion (ROM) and strengthening of the muscles which surround and stabilise the knee. Most people get back to their previous levels of activity or sport. If there is a very slow or difficult progress towards normality, anterior cruciate ligament damage or a meniscal tear should be considered.